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NPI 1043318090

NPI 1043318090 : SUJATA CHAVA M.D. : LULING, LA

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General NPI Number Information
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    NPI Number           |    1043318090
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    Entity Type          |    Individual 
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    Provider Name        |    SUJATA CHAVA M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    08/12/2015
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Provider Practice Location Address
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    Address Line         |    1057 PAUL MAILLARD RD SUITE 250
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    City                 |    LULING
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    State                |    LA
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    Zip                  |    70070-4349
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    Country              |    US
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    Telephone            |    985-785-5770
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    Fax                  |    985-785-7753
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Provider Business Mailing Address
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    Address Line         |    1514 JEFFERSON HWY 
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    City                 |    NEW ORLEANS
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    State                |    LA
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    Zip                  |    70121-2429
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    Country              |    US
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    Telephone            |    504-842-4000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    MD.15340R
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    License Number State |    LA
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